Soru

A 72-year-old woman is evaluated in the outpatient geriatric clinic due to progressive memory impairment and behavioral changes. According to her son, who accompanies her, she has experienced significant day-to-day fluctuations in her alertness and attention over the last 10 months. Furthermore, she frequently describes seeing detailed, silent figures of people standing in her bedroom. Her sleep is often restless, and she frequently shouts and thrashes her arms as if she is acting out her dreams. On physical examination, the patient has a mask-like facial expression, a resting tremor in her left hand, and cogwheel rigidity in both upper extremities. The physician explains the likely diagnosis to the son and discusses management options. The physician strongly cautions against the use of a specific class of medications to treat her perceptual disturbances, noting that it could trigger a severe, potentially fatal reaction characterized by irreversible parkinsonism and autonomic dysfunction. Which of the following medications is most likely to cause the severe reaction described by the physician?